“We believe adding this enzyme copy, hrsACE2, lures the virus to attach itself to the copy instead of the actual cells,” Mirazimi says. “It distracts the virus from infecting the cells to the same degree and should lead to a reduction in the growth of the virus in the lungs and other organs.”

The current study was limited to cell cultures and engineered miniature organs. However, the same drug has already been tested against acute lung injury, acute respiratory distress syndrome and pulmonary arterial hypertension in clinical phase I and II studies.

The researchers note that the current study only examined the drug’s effect during the initial stages of infection and that further research is needed to determine if it is also effective during later stages of disease development.

ACE2 usually helps lungs and other organs to maintain normal function but when viruses bind to the protein they could damage the cells. This could, according to the researchers, explain why some COVID-19 patients suffer severe lung disease and multi-organ failure.

Key info on disease development

With the help of the organoids, the researchers were also able to show that the virus can directly infect and multiply itself in blood vessels and kidneys. This provides important information on the development of the disease and the fact that severe cases of COVID-19 present with multi-organ failure and evidence of cardiovascular damage. hrsACE2 also reduced the SARS-CoV-2 infection in these engineered human tissues.

“The virus causing the COVID-19 is a close sibling to the first SARS virus,” says Josef Penninger, professor in UBC’s faculty of medicine and co-corresponding author of the study. “Our previous work has helped to rapidly identify ACE2 as the entry gate for SARS-CoV-2, which explains a lot about the disease. Now we know that a soluble form of ACE2 that catches the virus away, could indeed be a very rational therapy that specifically targets the gate the virus must take to infect us.”

The study was financed in part by the Swedish Research Council, the European Research Council and grants from Canada for COVID-19 research. Several of the researchers report conflict of interests, including Josef Penninger who is a founder and shareholder in Apeiron Biologics. Please see the study for a complete list.